From Finger Injuries to Neck Pain: The Jiu Jitsue Recovery Conversation Every Grappler Needs

Jiu-jitsu injuries, BJJ rehab, finger injuries, neck pain, leg locks, physical therapy, and longevity are all part of the reality of staying on the mats long term.

In this episode of the Doctor Jiu Jitsu Podcast, I sit down with Eugene Tsozik, physical therapist, jiu-jitsu black belt, founder of The Jiu Jitsu Therapist, and co-host of the Chewjitsu Podcast.

This conversation is all about what grapplers need to understand if they want to train hard without constantly breaking down.

We talk about the injuries that show up most often in jiu-jitsu, including finger injuries, mallet finger, neck pain, cervical radiculopathy, knee injuries, leg locks, bursitis, and the long road back after being cleared from traditional physical therapy.

One of the biggest takeaways from this episode is that “cleared” does not always mean ready for jiu-jitsu.

Grappling is different. You are not just returning to running, lifting, or controlled movement. You are returning to a live opponent who can stack you, twist you, pull you, and put your body under pressure from unpredictable angles.

That is why rehab has to respect the sport.

We also get into longevity, strength training, mobility, grip management, load management, and why what you do off the mats matters just as much as what you do during training.

If you train jiu-jitsu, coach grapplers, treat combat athletes, or want to stay healthy enough to keep training for years, this episode will give you a smarter way to think about recovery, injury prevention, and performance.

New episodes of the Doctor Jiu Jitsu Podcast drop the first Friday of every month.

Timestamps:

00:00 – Welcome to the Doctor Jiu Jitsu Podcast
00:55 – How Eugene Started Jiu-Jitsu During PT School
04:22 – Training Through Medical School and Injury Fear
09:23 – The Most Common Injuries in Jiu-Jitsu
10:17 – Finger Injuries, Grip Fighting, and Hand Health
17:37 – Neck Pain, Numbness, and Cervical Radiculopathy
23:57 – Why “Cleared” Does Not Mean Ready for Jiu-Jitsu
32:02 – Dangerous Positions, Stacking, and Leg Lock Awareness
40:13 – Strength Training, Mobility, and Longevity for Grapplers
52:07 – How to Keep Training as You Get Older
58:05 – Knee Bursitis and When It Becomes a Problem

To learn more about Dr. Megan Jimenez, check out her website: doctorjiujitsu.com

Transcript

Narrator [00:00:00] Do you train combat sports? Have you ever been injured? Dr. Megan Jimenez is an army orthopedic sports surgeon and jujitsu black belt. This is Dr. Jujitsu, your go-to podcast for combat sports, military performance, injury prevention, and treatment. New episodes drop the first Friday of each month. 

Dr. Jimenez [00:00:22] Hey guys, welcome to the Dr. Jujitsu show. My name is Megan Jimenez. I am an orthopedic surgeon and Jujutsu black belt. I'm here with a good friend of mine today, Eugene Tsutsik, Tsozik? Tsozek, close enough, sorry. Tsozuk, still working on it. The Russian last name. But he has graced us with his presence today. I'm so grateful to have him. It's been a work in progress. He is the founder of the Jujutu Therapist and you guys might know him from the Chewy podcast, Jujitsu podcast. He is one of the co-hosts and welcome to the show. Thanks for being here, man. 

Eugene [00:00:53] Thank you, Megan, thanks for having me. 

Dr. Jimenez [00:00:55] Yeah, so let's start out with your origin kind of being a jiu-jitsu black belt and physical therapist. You're the second person I've had on the show that has both of those credentials. How do you intertwine them? How do they kind of mix? 

Eugene [00:01:11] So I actually was in, it was in PT school and grad school when I started, um, jujitsu is, uh, I don't know. It's like I had a buddy that I had worked with that said he taught wrestling at a gym. And so I was like, okay, uh I'll show up. I've always been like I watched the UFC, which is kind of very typical. Like my dad would bring home the VHS tapes and me being Russian. Um, Oleg Tatarov was like on UFC six. That was like the first VHS we got. Me and my dad watched it, and I think Oleg ended up winning. I was like, this is so cool. So I had a connection kind of to a fighter initially, but I always loved watching it. And I remember being in college and undergrad and like, just. Very intrigued by by like the ultimate fighter I was so excited about that show people didn't know really about it but I was like I've been watching the UFC since I was 10 and this was like 12 years later or something but I don't know if it really intrigued me I just thought it's not anything I could ever do you know hoist Gracie stuff was very cool to watch you know in the early UFC's but um but I had a buddy that that taught some wrestling that I worked with and he's like, you should show up and. Called him that day and he never answered but I showed up at the gym anyways and I was the only person in the beginner class so I basically got a private lesson I was like this is this is crazy I was just like had this weird smile on my face the whole time like I was this is cool I'm actually doing like a martial art something connected to you know to jiu-jitsu and so I just kept showing up kept coming to the gym and you know that was in 2008. Uh, when I started and it was, there's a little bit different environment back then. It was kind of a little bit, uh, you know, survival there, they're trying to, you know, harden you a little bit and see if you belong. They want some tough guys at the gym. And, um, I wouldn't say I was the most tough guy, but I just kind of kept showing up. And so, I mean, that was kind of the start of jujitsu for me. 

Dr. Jimenez [00:03:14] So you were in PT school. 

Eugene [00:03:16] I was in school. Yeah, I was probably my first or second year I graduated in 09. So it was probably midway through and I just kind of started. It's just something I did. I don't know. I couldn't ever really go a ton. I mean, if you're in grad school, if somebody's ever been in grad school, you know, you're like, frickin consumes all your time. So like a couple days a week, I could I could get in there and get some training in it. I think it was a really, really good break, like a mental break, just from The stress of studying all the time and I just enjoyed I was drawn to it. I was actually very interested in how The the physical therapy side and the jiu-jitsu side were connected. I never really put those two together Like I never thought it would be a thing that I could actually Work into my life as like hey I do jiu jitsu and also can help people with you know getting back to jiujitsu or staying healthy on the mats, but it was It was cool to just kind of figure it out and see the connection of how the body moves and kind of how things are structured and work together. 

Dr. Jimenez [00:04:22] It's funny because I started in medical school, residency area, and so I had an experience, a lot of experiences where people tried to convince me to stop, right? All my orthopedic surgeon mentors and people that know a lot about the body and what they would see what I was doing or hear about what I doing and, you know, I'd come in with injuries. I had my first surgery on my shoulder pretty quickly after starting jiu-jitsu, so everyone told me I couldn't do it anymore, but it was devastating to think I couldn't or wouldn't be back on the mat. So did you have that similar experience? 

Eugene [00:04:53] It was actually my parents, my parents kept telling me I was gonna get hurt. And I did initially like my hands and my fingers. I broke my thumb. I think initially I was actually doing a rotation and so I had to like, you know, broke my thumb in the middle of it, like just after when training and so like I have to like wrap it up essentially it was just like the the joint so wasn't terrible. Like I had like a little cast I would wear every now and again, but like when I was in the clinic doing stuff, I would. Just take it off and tape, like tape my finger up a little bit. But that was like the main thing. So the fear of injury was a big thing for sure. Just not being able to work. Cause what we do is with our hands, right? We gotta have our hands. That's like our tools. So that was a bigger fear initially. And I kind of didn't have that much of a fear, but like my parents would constantly be like, hey, you're working towards this thing. You spend a lot of money, a lot time. Like you don't want to hurt yourself and not be able to do the thing that you've been going to school for. 

Dr. Jimenez [00:05:51] Yeah I had similar experiences. When I had my shoulder surgery, I think I was an intern and so I was just starting residency and all my seniors, you know, residency is five years for orthopedics. So all the people above me, they were like, you can't be doing this. I was in a sling and they had to rearrange all the schedules for all the residents to help me out. I couldn't take call for a little while because I couldn t use my right arm. And so every time I'd get an injury, it would repeat in my head kind of, what are you doing? But then the thought of not being back on the mats devastated me more than an injury. Yeah, for sure. So are there any specific injuries that you see Jiu Jitsu athletes have that kind of gets you more interested in physical therapy or helps you make this brand? 

Eugene [00:06:33] So what happened actually how how that came about how I connected the two is we talked about Chewy Who's uh, who's my coach? We've been good good buddies for a long time I actually started a different gym and then when that gym closed I moved to chewie's gym was probably an 09 or No, it's probably 2010. It was 2010 when I saw i've been with him since then And so chewie at that time was still fighting ma um, he's fighting professionally and he was In the middle of his training camp and I happened to be on the mats doing something. He was training and like he like tweaked his knee and You know, they called me over like, hey, can you look at the knee, make sure everything's okay. And so I kind of did, you know, my hands on assessment and I kind Of mess with him a little bit. I knew it was okay. It was a you get kind of And I don't know this about, you Know, I never fought him a but he I mean, everything is so important. There's a lot of mental it's a mental game to like you want to be as healthy as can be what your prep to go perfectly. I think like you worry about any little thing. But I assessed his knee and everything was fine. I said, Hey, dude, you're gonna be fine. Everything's okay. I think you just kind of like, tweaked it a little bit and everything structurally was was sound. And he kind of, like had this like, Oh, all right. Thanks. I feel much better, essentially, like he just knew it wasn't anything serious to worry about, I think. And was able to. Continuous training camp and everything went well. But I think just being able to do that, I was like, whoa, that was interesting. And so that kind of got the ball rolling for me and he kind of encouraged me to a little bit like, hey, because he's got his own brand and his own business and just kind of how to start that process of like starting to treat people. Because I would just see people at the gym for free. Someone wanted me to look at something, I would give them. Full-on assessment tell them what to do and help them out and I never thought that I was like he's like dude you you have a Skill set and a knowledge base that like you've spent a lot of time effort and money to get don't give it away for free Don't give away like it's valuable. So you have to I think see value in it yourself He helped me see value and it myself that was worth it that I you know Hey, if somebody wants to use my expertise and my knowledge the you know, my time is valuable, it's worth it. So that was the initial kind of start of it. And then I just slowly started to grow, grow some clients and people kind of knew that was the physical therapist at the gym. And so people would seek me out, you know like, and Chewy is a great resource, because he's like, everybody, you know, everybody in the gym trusts him. He's the head coach, he's okay, I go see Eugene, go go talk to Eugene to see what he knows and see what you can tell you. And so that that's kind of how it started. And it really was was a nice boost. And I felt like it's it's something that I could. Potentially work towards. 

Dr. Jimenez [00:09:23] That's awesome. And what are the main injuries you're seeing now with your brand, with your business? Oh, I mean... 

Eugene [00:09:32] You know, you see the typical stuff. I mean, honestly, shoulders, knees are very common. You know leg locks. You see some knee injuries for sure. You see, some neck and spine stuff. But like I think a lot of, you know, shoulder shoulders and knees are pretty common. Again, spine is also common, but that can be variable on the type of injury and things like that. Some sciatic kind of stuff low back pain, of course, as well. You know flexed all the time in jujitsu and but those are probably the primary primarily one some other little outliers, you know see some wrists and finger injuries are Pretty easy to treat for the most part But that does become main stuff 

Dr. Jimenez [00:10:17] Going to finger injuries, so I recently had one like two months ago, just extended my finger, got a volar plate injury. And I'll tell you, it's been two months and it still hurts. It still swells. It's wild how long fingers take. And I've got partners, I'm a sports surgeon, so, I have partners who are hand specialists and they were like, it was going to be fine. Like tape it, do your thing, but it's going to take forever. Like that's the problem with fingers. And I think. I don't think we let them heal enough and that might be why we get the jiu-jitsu fingers. They're like crazy deformities of the fingers Yeah, people just Go go go go. Go. What do you have advice wise on fingers? What do think the trick the way the best way to treat them is so that our hands don't get mangled? 

Eugene [00:10:58] I think you have to vary your grips and vary what you use. I mean, I do Guianogi, but I'm going to switch up my grips. I'm not going to, you know, just do a bunch of spider guard and grabbing sleeves. I mean I've got, you know, I don't know if you can see I've injured this finger twice. I had an extension injury to the extensor tendon and then like one of the ligaments on the side. And, you know, you just have to kind of vary your grip. Some stuff is going to happen. But if you use lapels, it's just going to be a matter of time, probably before you hurt yourself. But I also think, I mean, you can hurt yourself Nogi as well. I mean if you plant or I hurt one of my fingers, we were doing grip fighting and like my finger got caught essentially and like on their head or something. And so you can injure in a lot of different ways. I just think you have to in this happens with experience, you know, when you're starting to lose a grip, let go preemptively and re grip, like get good at re gripping, letting go and re griping. So you're not getting your fingers constantly like. The breaking of the grip is kind of uncomfortable, and it can cause some, I think, some damage repetitively, varying your grips. I will tape, I'll tape my finger. I've got, you know, my middle finger here is pretty gnarly here, but I will take that, and just, I mean, taping can be helpful. It's not a substitute for like proper health of your fingers and your hands, but just like knowing kind of what your grips are. Not having a death grip, letting go on time, re-gripping properly, varying your grips. I mean, those are some other options. I think that's the main stuff. There's no way to avoid injuries for the hands or any joint whatsoever. You can mitigate some of the risk of injury, but there's no to avoid it. 

Dr. Jimenez [00:12:45] Yeah, I also have friends that don't care. They mangle their hands. One of my professors, we call him like old man and grandpa because he's, he's probably, I think he's in his 50s. But we all, I'm like, we're like happy 85th birthday, you know, he was older dude. And he was streaming the other day, he can take his small finger and just rotate it like all the way back to the back of his hand because he has torn the ligament so many times and didn't even care. He's like, I still can do everything. Like this is just a little floppy. Like, so it just kind of, I mean, it depends on what you you're right, so. 

Eugene [00:13:12] Yeah, and we have a little more we our hands are you know, we're not just doing jiu-jitsu We're working with our hands a lot and I think it's important that we have good Control and dexterity and function in our fingers and our hands. So yeah to each their own, you know If it's like hey if I didn't do what I did, I just did jiu jitsu all the time I probably wouldn't care as much but again, you it's it's a risk for for us using our hands 

Dr. Jimenez [00:13:37] Yeah, I mean after I hurt my finger, I was prepping for pans and it was the weekend before and I was like, well, I'm not doing pans, but it was a tough decision to come to you because the competitor in me said tape it and go, but I could barely close my hand. And so I bailed on that one and then competed a month later, still hurting, but better. And I remember just scrubbing into surgery a couple of days after the injury and I had to be so delicate with the glove and then I used sterile tape to buddy tape my fingers in surgery. And it worked for the pain and it was everything was fine, but there's a lot of different things to think about 

Eugene [00:14:13] Yeah, and the other thing is like some of the injuries you can work around, but if you don't treat them properly, you can have some deformities in the finger like one of these this one right here, my pinky had a mallet finger injury was so like the extensor tendon just I got a caught in a tour. And I was like, shit, I got, I kind of want to train but I know if I don't, if I Don't, you know, put it into extension and keep it for at least six weeks. It's probably not gonna heal. I'm gonna have a deformity in my finger. I may not be able to extend it. And so I was just like, it's not a big deal because you can train with that stuff. It's not big deal. But I didn't wanna have dysfunction in my fingers. I wanted it to work normally. And so, I mean, I had a tournament actually coming up and it's like, oh, I can't compete because of my pinky finger. It's like the most ridiculous thing, right? 

Dr. Jimenez [00:15:04] Oh yeah, I got made fun of. They were like, you're not going to go do that? I said, no, I'm a surgeon. And people were like oh, that makes sense. 

Eugene [00:15:09] Yeah, and so it's it's so silly like to other people, but because of kind of our dual roles in what we do and also in training, like we got to take care of our hands and so yeah, it doesn't make sense to some, but I think somebody in the healthcare field will understand the importance of it. 

Dr. Jimenez [00:15:26] Yeah, can you explain like mallet finger a little bit better because I bet you a lot of people have it and 

Eugene [00:15:31] I'll show it to the camera. So basically, the the pinky or any knuckle or any any finger, I mean, the very end of the finger, you can get your finger caught maybe in the mat. That's what happened to me, I got caught in the matte and it tore this little pulley essentially that extends or straightens your finger. So my finger would droop down, I couldn't straighten it, I could push it straight, but it would just droop. So Common treatment for that as long as you don't have a fracture. So for most people if you have this injury I mean and you're not familiar with anything about the hands or I don't even medical knowledge probably go get an x-ray to make sure there's no x-rays because sometimes you can pull some of the bone off but I Kind of knew what was going on. And so I Basically taped it straight I had to keep it straight for about six weeks Because if you let the finger droop at all that it won't scar back down and heal up properly so I was like I had a Splint essentially on my pinky Keeping it straight for six weeks and the thing and it's so gross because it smells so bad like after a while like and you Have to change it you have to really be careful changing like yours I had a couple little splints So you have two like I would push it against like the the table and keep my fingers straight and then like tape it up, so 

Dr. Jimenez [00:16:44] People are like how do I shower when I have these like because it's just the end joint, right? It's just yeah, and so people are like, how do i shower? I think well you take the splint off Hold it put it against the shower wall, you know, cuz you know 

Eugene [00:16:56] you don't want it or just wear it and then just switch it out when you're out so that's what i would do it was so funny my brother did the same thing and before i did it he doesn't train jiu-jitsu or anything but he was being a goofball just doing something and got and i had to trick he was like don't let it don't it don't let it bend don't like i got it i got I had to change his split form. I was like, dude, it's not that hard, but. 

Dr. Jimenez [00:17:19] But I'd rather that, at least he cared. 

Eugene [00:17:21] Yeah, yeah, I cared enough. 

Dr. Jimenez [00:17:22] Because the second that you let it kind of just be like change it, let it droop. 

Eugene [00:17:26] You're starting again, you're right off. 

Dr. Jimenez [00:17:28] So yeah mallet fingers fun 

Eugene [00:17:30] That's annoying. It doesn't really, you know, it's just annoying. Your finger looks funny. Yeah. 

Dr. Jimenez [00:17:37] So, keeping on, I kind of want to go over a couple injuries. We talked, before we got on the podcast, we're talking about cervical radiculopathy, which I think is pretty common. I have it, so it's kind of near and dear to my heart, sadly, from all of my years of training and probably just inverting too much and going with big dudes, getting stacked, just not thinking about it early on. And what do you think about this? Because I have a lot of people that talk to me about numbness tingling in their arms. And neck pain and trying to get advice. I have a guy coming on actually. He's a good friend of mine. We did residency together. He's spine surgeon and a purple belt in jujitsu. And he's super conservative, great dude. So talk to me about what you do when people come to you with these neck problems. 

Eugene [00:18:20] I mean, you have to, the number one thing is you have to try to address the numbness, the tingling. That's kind of an important thing. So we have to find positions maybe that relieve that. I mean that could be definitely, it just depends on kind of the origin of where, and you know this, like the origin of where like the compression, if there's a compression or a nerve, some type of nerve dysfunction, you gotta figure out where that is and try to adjust it, whether it's, you know. Working with the joints and to get those moving a little better, some, some stretching or even just specific strengthening and mobility exercises to kind of get that to resolve. Um, and there's different things we do hands on and nerve glides and different things, but that's the most important thing is trying to get that, uh, those symptoms to kind of resolve. Oh, it depends. I mean, that's that's a tough question. Maybe it depends on if it makes it worse or not. It depends on If there's any kind of weakness, you know, because that could be pretty serious. Like, if there was somebody coming to me, I would probably tell them not to I mean I just because I know how jujitsu people are and if you give them an inch going to take a mile. And so I probably wouldn't, like if it's somebody like, hey, I can train around it. And I don't know if I wanna say that because it's like my internal monolog coming through. I would say probably you shouldn't. I say you probably need to get that numbness tingling, whatever that is addressed, figure out what it is. Really, if you have that going on, it's not going away. You need to see a medical provider. That's probably the best option first. 

Dr. Jimenez [00:20:07] Yeah, because there's a lot of options. There's like physical therapy. Typically these things don't require surgery, but when they keep going, you can get injections into the spine, into the neck, wherever the compression is. And there are surgeries, and there are pretty decent, pretty good surgeries. I have a bunch of friends now on the mats that are 40s, 50s with disk replacements with various things, and they're still training. I remember my first time getting this numbness tingling got stacked by like a 220 pound chick. I think it was a white or blue belt, and she was a higher rank. So I should know better, but got completely stacked on my neck, radiating pain, numbness, tingling, it was probably 10 years ago. And I shut down jiu-jitsu. I couldn't turn my head at all. I was petrified, you know. And I thought I just had a little disk herniation and I said, oh shit, I got an MRI and my neck was already pretty arthritic, in bad shape, like chronic stuff. I was like, damn, I just started jiu jitsu like two years ago, but probably all the years that I've done some kind of martial art. And just beat my body up, right? So I got into the treatment of it a little bit later, but it's been about 10 years. And what I did was I switched from an inversion game to playing top only for like two years. And so I just got really into passing and all that. And then it got a lot better. But now back to the inverting game, we were talking before, it can hurt, you know? It can do some damage. 

Eugene [00:21:31] Yeah, I think I just gotta be careful not to You know with nerve pain and things like that You have to be patient with it And it takes a while as you know it takes awhile for it to resolve and it can come back if you aggravate The area so you have to Be mindful. I do think it's it's If I had somebody coming to me initially, I'd be like hey we got to get this to resolve So I probably wouldn't have them trained because I think it just you want to try to work around kind of those symptoms if you can. But a lot of times it's hard and jujitsu people are grabbing on your neck and it might stack you and you can't avoid certain things. So yeah, I'd probably have them treat it, try to get that all that stuff to resolve before they go back to training. 

 Dr. Jimenez [00:22:15] Yeah, and then go back with good partners like hey look when I've gone back in the past after an episode like hey Don't touch my neck. Please don't touch me at my neck Don't stack me and I try to do pay the same respect I was training for a comp once and my friend she she'd go to color time me and move her hand and then I wouldn't Call her to her. She's like but you have to call her time And I kind of was like well if you're not allowed to that's not fair. So right just adjusting with good people 

 Eugene [00:22:41] That's like, it's like kind of an unspoken rule. I've talked about this before. It's like hey, if I take some of your weapons away, then vice versa, let's make it fair. Because if you're like, hey, I'm hurt and you can't do these things to me, but I can do it to you, it just makes the role not as fun for the person. So it will make you play different types of, you know, attacks or do different things, but it kind of makes it a little more fun. And even if you are limiting certain aspects, certain body parts and things like that. So, yeah, I think it's. Picking your training partners and then getting somebody back. That's a big thing when somebody comes back to jiu-jitsu It's like I don't just send them off. Okay Go go do your thing because that's what jiu jitsu people think. Oh, I'm cleared those words Oh, you're cleared and they're like, oh shit. I'm clear. I want to go back to like Frickin do ten rounds today and go as hard as I can cuz I haven't been able to train I got to catch up for a lost time kind of thing. It's just crazy. So you have to When you're going back to training or some type of sparring or rolling, it's gotta be, you gotta give them a smaller sandbox to play in first and certain restrictions and then as their body starts to adjust and you make sure their symptoms stay managed, then you can start to give them a little more wiggle room to play with. 

 Dr. Jimenez [00:23:57] Yeah, and our mutual friend Mike Piekarski. I hope I say that right. I've been trying to say his name for so long But he also jujitsu black belt therapist. He's got a really cool timeline That I took from one of his courses And it kind of is a timeline based on what the injury was And then what they kind of can and can't do jujutsu wise right because that's an area that Us as providers if you're not into jujitsu, which most orthopedic surgeons are not most doctors are not they're like You're cleared, and that's a problem, because you're cleared to anyone, right? You're not gonna tell a weightlifter or a soccer player you are cleared until they've done sport-specific stuff. And I think it's a program all around. So going on that, what are problems with athletes, jujitsu athletes seeing providers, physical therapists, anything that don't understand the sport? 

 Eugene [00:24:51] Think if you're seeing a physical therapist that doesn't do the sport in some capacity doesn't do jiu-jitsu isn't on the mats in some Capacity it's going to be very limited. I think it's going to Be a poor recovery because they're not going to understand the the requirements the prerequisites for jiu jitsu the positions the the places you're going to end up in with overpressure from somebody else. So I think It's so valuable to have somebody with a base that can actually close that gap. Because when you do traditional physical therapy, and then you go to back to training, there's this there's a huge gap where there's fear of re injury, right? There's there's like the movement like mechanic, do you have the mechanics back? Do you have the capacity to do what you need to do on the mats? Like, can you do this by yourself first? Can you sit on your heels? Can You deep squat? You know, can you hinge properly, like it's just. Can you lay on your back and bring your knees to your chest? Can you roll to your shoulders? Because somebody's gonna put you there if they stack pass, you know? So you have to have the capacity to do these things in a way that doesn't cause you pain that you feel comfortable with. And that varies for injuries and how long somebody's been out and how comfortable they are. So I think there's such a huge gap between traditional physical therapy and return to. Grappling and that's kind of where I feel like my little piece of the pie is like you can go see whomever and they'll give you The little rotator cuff exercise, whatever they'll get you back, you know, get your range of motion back and get you some strength back But do you have the adequate movement the movement patterns the strength? You know under load and different scenarios and situations are gonna end up in because it's not just like moving a dumbbell It's like I have to I have a moving opponent that might be on me and provide Resistance in different ways. Can I do that? You know off my back on my side, you know, so There's just a lot There's a lot missing there in traditional physical therapy and I see some physical therapists out there that are like in the rehab You know jujitsu space and they're like white or blue belts and not to take anything away, but you don't have I feel like the prerequisite understanding yet Of being on the mats long enough And maybe they do, maybe they did. But I just think like, there's some risk there of getting somebody back if you haven't been on the match yourself very long. 

 Dr. Jimenez [00:27:26] Yeah, I think coming back after my ACL surgery and then I had an ACL sprain on the other side a couple years later I had I was in different parts of the country different physical therapists, but none of them ever did jujitsu I just they had it but I had a Like they cared they wanted to learn so I remember putting one of my physical therapists like here in the army base We're sitting in the middle of all these Soldiers working out next to us and I laid him down and put him in a 411 And I was like, this hurts, you know, when they rotate my shin this way and he's just sitting there and I literally had my physical therapist in 411 on the floor and he wanted to know. So then we worked to be a rotation things and he adjusted it to that. So if you can educate your physical therapist, but you just want to make sure that it's not going too far right after you've cleared the regular physical therapy program, then finding perhaps somebody like you or Mike, somebody who knows it. To get you back to sport safely. Like, yeah, you're cleared from regular physical therapy, but maybe there needs to be a jujitsu therapy. Return to sport protocol, just like any other sport. We get return to sport protocols for soccer, for basketball, for football, doing different drills that are gonna get you ready for when you're actually having to go to contact, and it's slowly built over weeks. Versus you're clear, go do a full sparring competition round. 

 Eugene [00:28:48] Yeah, and then that's where like positional sparring, positional training, positional drilling, all that comes in because we try to, I want somebody to have the room to play a little bit, but also keep them restricted to where you avoid maybe some of these scrambles where some injuries could occur potentially. So yeah, I mean, it everybody's a little different, you know, depends on the injury and depends on their their skill set and their comfort level. The one thing that you mentioned kind of return to sport protocols is it's a challenge with jujitsu because we're not a field based sport. There is some standing but there's also some you know some lunging or like takedown so there's some standing some hopping maybe a little jumping a little bit here and there you know think about you know maybe like somebody has a single leg and you're hopping around trying to you know keep your balance kind of thing so that's important to work too but I don't know if there's an recorded. Maybe mike and I can put our heads together a little bit see like if there's like a return to you know Sport testing protocol like hey, these are like they have it for acls You know you have the like a y balance a single leg hop, you know some different things like that But I don't think there's anything Perfect for jiu-jitsu and maybe it could be a combination of things But um, it's kind of tough but making sure you do have adequate strength adequate mobility And then you're able to get back gradually. I mean, I think it's super important. And it's specific to the individual too. It's not just like, only time based. It's also like capacity, what's their capacity for? And what can they do? 

 Dr. Jimenez [00:30:26] Yeah, Mike and I talk about it all the time because all of our orthopedic protocols, there's time-based, right? You had a labrum repair of your shoulder four to six months. You had an ACL nine to 12 months. But I explain to my patients, like, that's not hard and fast. Do not go by that. That's approximates. Because if you're not ready and we return you faster, then we could have problems down the road. For sure. Right? So you could go back at four to 6 months because that's what the paper says. But then you might have pain for another year. Versus we could just wait a couple more months maybe and get you back 100%. So it's an interesting dynamic when we talk about numbers because all the literature, all of our orthopedic literature has, this is how many months this takes, this is many months that this takes and it's just not true. It's not a one size fits all. 

 Eugene [00:31:09] I use it as a speed limit, like, hey, we can't go past this, like maybe you're not going to go back to training before this time, just because of the research, you know, for ACLs, for example, you know, nine months is kind of the minimum, but every month after that, you know, a year after that like your, and every month, so on, like your risk of re injury decreases. So, you know, if we're a little more patient, even though you could go back and in some capacity, you you will be back training, but maybe not full on competing in certain things. So, and it's a great approach right we're going to give you a little bit and let you work and get you comfortable make sure your body can adjust and adapt to it and you're not training too much you have the appropriate protocol like as far as like frequency of training and intensity of training. I think those things are all important and they're a little bit like you said there's some variability depending on the person on their symptoms, how they're feeling. 

 Dr. Jimenez [00:32:02] Yeah, so as a physical therapist with all the positions that we put ourselves in as jujitsu athletes as grapplers Are there any that make you a little bit more concerned? 

 Eugene [00:32:15] You know, obviously when we talked about this getting stacked like that that you it's okay to get into flexion flexion is a normal thing in Jiu-jitsu. There's no neutral spine in Jiu Jitsu. We have to get flexed and rounded It's just being flex and rounded under load which you have to kind of work towards to be comfortable with so you have to choose who you do that with and how much you do it so I think you know that getting stacked or getting like, you know, that that the flexion stuff because It's very effective, especially for smaller grapplers for like guard retention and getting into some entries into leg locks and things like that. So it's useful. However, you have to kind of like anything like we talked about, you to kind of rotate the tires a little bit, use that a little, right? Find the right person to train or use that technique with. And some people you just may, you may avoid that you may play top game, right. So being able to do those types of things. The knowledge base for people in leg locks is important. So like leg locks and honey hole and those type of things, those aren't necessarily dangerous. It's just knowing when you're in trouble, right? It's like a Kimora, white belt's learn Kimora's and Americana's, right, but we're not cranking those things, we're going very slow. And you know when you are in a bad spot, you gotta tap, same thing with leg locks. Like if somebody starts to put some load on it. Don't feel like you can fight out of it if you feel like you're stuck. I usually on the mats. It's like, you know, we will do some release it like I will sometimes have like somebody in a submission and I hold it and I look at them and it's like three to four seconds and they're not moving. I'm like, hey, I got you. You're not getting out of this thing like and sometimes I'll let go and sometimes will say, hey, dude, like you're in a bad spot. And we may reset or I may just let go and afterwards I may say, Hey, if you're stuck and you can't move, you know, maybe just tap or whatever. But 

 Dr. Jimenez [00:34:17] I tend to let go a lot on those like I had somebody in a nasty inside Ashi yesterday and he couldn't move like there was no way But I saw his knee rotating the wrong way and I just let go and maybe I need to be more vocal and be like hey Listen, you need to Be more careful, but it's it depends on my relationship with the person like if I just I'm you're i'm not gonna hurt you but everybody doesn't show you the same respect back, right? I am so I tell people i'm probably one of the best people to roll with because I'm not gonna hurt you on purpose, right? There's gonna be no risky shit that I do. I'll put you in something and I am out because I'm gonna put your knee or your anything into danger, right. When people invert, I will not put their feet to the ground and put full weight on them. Like yeah, I'll their feet to the round, find no weight and I'll let the mat roll out. But sometimes you're not given the same grace, right Mm-hmm. 

 Eugene [00:35:09] You have to kind of, you know, especially if it's somebody you don't know, you have to kind of be on the defensive a little bit as far as if you're caught in something. And but yeah, just having knowledge. So we teach our white belts, leg locks and leg entries. Maybe they can't use them in competition, right? They can't you certain things until blue or purple belt. It just depends on what what tournament format you're in. But it's good to know, right. It's like the more you know that you're in a position, you're in trouble, the better you're going to be. More edge if you're in a position I had a this was probably I was a purple belt maybe and I put a guy in like a leg lot it was in the gi too so it's like it wasn't anything rotational but I had his ankle and like he literally spun out and I heard his knee tear I'll never forget that sound he was a blue belt maybe I'd never rolled him before and I wasn't doing I just grabbed it and I held and he just like freaked out and twisted out and his knee just ripped. 

 Dr. Jimenez [00:36:06] You just had like an Achilles lock, something not even that dangerous. 

 Eugene [00:36:09] It's been so long. It wasn't anything rotational. Like I literally had like, yeah, just like I had control of the foot. It could be like, yeah, like an Achilles, like a straight ankle. And I think I was on bottom, he was standing and he like lifted his foot and then like try to twist out, like run away. Yeah. So, you know, have a knowledge of it. It's really important. 

 Dr. Jimenez [00:36:31] I think that is fantastic, what you said, the knowledge of it. I teach no-gi at my gym, because I love no-ge. I think the mental aspect of leg locks, just in itself, I love to get into the weeds on it. A lot of times way too crazy. Not everybody loves it, but I have so much respect for it because I tore my ACL not respecting a heel hook and not realizing how much of a dangerous position it was. So I've got the teenagers now in my class, like 13 year olds. Starting into my adult advanced class on Tuesdays and Fridays And so I'm teaching them leg locks heel hooks like they're learning all the positions and and I think it's important And I argue with people sometimes about this like oh, we don't teach white belts leg locks We don't people I'm like if I'm doing leg locks that day, and it's your first day in class granted I teach mostly advanced, but sometimes on Fridays. I get white belts and like you know what we're gonna learn this the safe way You're gonna know when you're in danger. You're going to know how to keep your partner safe and when we're going to tap, how to rotate the correct way. I think it's just so important to get that early because I didn't get it early. I went to purple belt, started trying to leg locks, and it was scary, right? Because you're like, I'm a purple belt. I can do this, but it's a whole different language. 

 Eugene [00:37:46] It is it's I think of it as like a like a gunfight like or a duel like you know that we got the western like it the old timey western movies and they're walking away and they turn around and whoever hits each other you know who pulls the gun out first I think it's like a firefight because they have access to your legs you have access to theirs it's like who's first right so it's a little bit of a It's a risky position, like if you're going against a leg lock battle, because it's going back and forth and submissions can happen very quickly. But you're 100% right, like, if somebody doesn't know what they're in, they don't understand what position they're In, they could move the wrong way. So at least teaching them like, hey, if you've caught here, this is a good time to tap. And that leads to another point is like, make sure you're not eating submissions, Like, you've got teenagers. They're bendy and flexible and their bodies can do all kinds of stuff that us older people cannot but if you let your joints constantly hyper extend and get tugged on you're going to create some issues there you're gonna create some joint laxity you're, gonna create, some problems and possibly some chronic issues and you're. Going to mess with your longevity on the mats and so if you're a younger grappler and you want to do this for a while don't let your stuff Get. Hyper extended and tugged on, you know, you have to understand that even though you can eat a submission doesn't mean you should 

 Dr. Jimenez [00:39:14] Yeah I've had a couple women women like that too, right? Where I'll have them in something and their arm is just bent way further than I could even and I won't let him get That far, but I'll start inching and I'm like That is not a great position. They're like, oh, yeah I don't really feel anything and it's kind of like an education thing of you might not feel it But you're so flexible that at the point you do have an injury is gonna be so far gone It's like a leg lock, right you don't feel it You don't real feel your knee, but there is pressure and maybe something you don't really feel pain per se and it's the knowledge to say, okay, that's good, I don't need to test that anymore. 

 Eugene [00:39:49] Yeah, and some of those are submissions like leg locks, they don't hurt until they do, right? It's like you don't feel anything and then all of a sudden, bam, something moves, something pops, something shifts and that's it, right. So it's like, don't wait till the point of, because there's not enough time there. You know, there's no enough time for it to, yeah, once it hurts, it's usually too late at that point. Yeah. 

 Dr. Jimenez [00:40:13] So I want to transition over to, like, longevity, doing what you do off the mat. Before we got on the podcast, we were talking about young guys, like 20-year-olds, that have been doing it since they were kids, and all they do is jiu-jitsu. They don't have any kind of cross-training, they don't do anything else. And I was like that, too, when I was starting out. I went to residency, and I trained jiu jitsu, and there wasn't really time for anything else, but now I'm getting a little older, and I have more of a routine and a lot of other things that I do besides jiu Jitsu. What does kind of a typical week look like for you? What do you recommend? How do you recommended people train outside of jiu-jitsu? 

 Eugene [00:40:49] So I'm 42 with two kids. I have a son that's 10, a daughter that's eight, and also have a wife. So it's like, you know, I have family responsibility. So when I train, so we'll start with that training is about two to three days a week. Three is perfect for me, but sometimes three is tough to get. So two days a week is usually my training and I try to be very intentional with training. There's usually something I'm working on when I'm on the mats. I weight lift three days a week. I have a push pull legs. I made a gym in my basement just so I can work out and get to the you know, really strength training. I think that's one of the most important things is strength training, especially as you get a little older like I wish I would have strength trained as consistently and had the appropriate diet and recovery like as far as and recoveries like you know making sure I'm adequately hydrated and have you know, eating well, and sleeping enough, those type of things. Those are key, right? So strength training, outside of jujitsu, and then doing some some joint training. So specific joint training, one of the things that people don't that neglect, I feel like people neglect a lot is rotational training, specific joint training that's something I did like I just kind of drew me to I did the FRC, you know training, I went through that. The functional range conditioning. So I did some classes on that and some training on that and just working on rotational training, working on end range isometrics to build some improved joint health, joint capacity and so ability to move. So that's important. What would be some examples of those? So like cars, joint circles, controlled articular rotations or joint circles. So you gotta think a lot of injuries in jujitsu are rotational. Like kimura americana for doing for a heel hook that's a rotational stress on the knee the ankle So i'm training rotational components. Um, i'm either doing You know a warm up through the joint circles. I'm doing some end range isometrics where I get to end range and I work Some activation to make sure I have good control. Um i'm working to build more movement if I need it I'm not trying to say like, oh, you're going to be able to fight off a Kimura if somebody's got it locked in completely, but I want to have the awareness that I'm in a bad spot where my arm is in space, that I have some adequate control there and have enough mobility that I can at least have enough time to tap. 

 Dr. Jimenez [00:43:29] Strength and stability like strength and stability at that motion sure you're gonna tap but it's not the it's gonna end your 

 Eugene [00:43:36] I have some control there where I can maybe just get myself a little bit of Stability where I could have enough time to tap right now. I get my shoulder blown out 

 Dr. Jimenez [00:43:44] What would be an example of like how what would a car be or what would you do for your shoulder? Maybe would you, do it on like push day you would do these cars or? 

 Eugene [00:43:54] So it depends on I do like daily probably like you can do the three to five I'll do them as a warm-up for my shoulders. I'm doing upper body. I'll Usually as part of my warm-ups for jiu-jitsu When i'm running class, I coach on thursday mornings And so we'll do if we're working something with the legs and hips we're doing hip circles and some hip activation exercise Kind of some contract relaxed type stuff just to get the tissue activated a little bit warmed up 

 Dr. Jimenez [00:44:20] What does that look like are you like on are you in turtle like on all fours doing a hip circle are you standing? 

 Eugene [00:44:24] You can do standing, you can do on hands and knees, you on your side usually because balance can be an issue. And so if you don't have access to a wall, you're just gonna hands and needs, you can do some circles. But then we'll get in a 90 90 like an S mount position and work on some dynamic kind of moving our chest towards the front leg towards the back leg, more of a dynamic movement, like pulling yourself in. I'll even work on having a 9090 and pulling myself into the position and pushing myself out through my legs, not even using my arms. So I'm kind of like getting the tissue to really activate. And then I'll go side to side, just trying to get those joints just to wake up a little bit, essentially. It's not like don't spend 20 minutes doing some kind of crazy warm up. Like you can do some adequate stuff, I'd say 8 to 10 minutes. But if you have an area of your body that's kind of problematic, get to class a little early and give it some extra attention. Do some of those cards and some of those specific movements. But that's the thing, there's so many avenues to take that. If you need more motion, if you need to warm up the tissue, if you to strengthen the tissue. If you to build more just joint health there. There's so may ways to use those rotational movements. So it's important, it's not really something somebody can pick up unless they're kind of working with someone that has some knowledge in that space. 

 Dr. Jimenez [00:45:46] Would the shoulder just look like a really big shoulder circle? 

 Eugene [00:45:50] Yeah, shoulder circle, we're going try as big of a range of motion as we can without pain, right? We don't want to cause any pinching pain. So you may work around any kind of discomfort. And you're just trying to move that shoulder in its full capacity and just kind of almost a lot of times I'll say like kind of greasing the groove, just trying to grease that tissue a little bit just get it primed and ready to move. I don't what my arm to be rotated in a weird way the first time I'm training like I want to at least have some If you're an older person or even younger, I don't know about how people feel. But like my first round of grappling, like my first round rolling is usually like I'm going pretty slow. I'm just let my body kind of get used to the movements. And so I'm usually not going very hard. So if somebody's coming after me, I, you know, I'll just play more defensive initially until I feel like my body's ready. It's almost like I I'm doing a scan of how I feel. Right and that's the same thing for your joints when you're doing those circles kind of like a way to self scan And see if there's any kind of funky stuff going on you can be like, oh that feels a little weird I might need to dress that or or keep an eye on that movement or or that area of my body 

 Dr. Jimenez [00:46:59] And the car should be slow, right? Because sometimes I'll see people doing these warmups and they're just like whipping their arm and not really doing anything. It doesn't seem like they're slowly bringing the join around into kind of more end range. 

 Eugene [00:47:11] There's such a, I feel like there's this connection, you know, if your brain's kind of focusing on what you're doing, you have to kind of be focused on what your doing a little bit. I think you have be intentional. If you're trying to get better at jiu-jitsu, you're intentional with your training. I'm working on this thing. If you go in and you just do whatever, will you get a little better? Sure, but you're not gonna get better the way that you want to. So if you go to the gym and you do random stuff all day, are you gonna get a stronger? Sure, are you going to make as much? Headway as you would if you're intentionally training or working on a specific thing. Absolutely not. And that's where, you know, coaching comes in in jujitsu, coaching or instruction comes in and rehab or, you know, just mobility training, things like that, so that you need some focused, intentional training or practice to get better, especially if you short on time. 

 Dr. Jimenez [00:48:03] What, when you're doing your push pull leg days, are there maybe one exercise per day that you think is super beneficial for grappling that will help, or that you do? 

 Eugene [00:48:13] Um, like just traditional strength training or. 

 Dr. Jimenez [00:48:16] Yeah, when you're traditional strengthening are there certain exercises you think okay, these are like I do these to get better at jiu-jitsu specifically 

 Eugene [00:48:24] I think an important one, I would say like it could be a leg day or pull day essentially is some type of RDL or hinging movement. Just because sometimes I'll work single leg RDL so it's like a hinging just because I think there's a lot of there's a balance component there and there's also some activation to the like the posterior chain the hamstrings the glutes, which I think is important if you're trying to pass guard and somebody's tugging on you. You got to have some resiliency there. That's a really useful one now if you're trying to build some strength there you want to take the balance component out of it You know, I use dumbbells like some heavier dumbbells. I'll do some RDLs that way. I think that's helpful just the post your chain I Definitely think like doing something like a row is important. I just think a lot of like, you know for squeezing pulling Doing a rowing movement or like working the shoulders the back of the shoulders The shoulder blades is important just because we're always so flexed and rounded so When you're doing any kind of pushing movement, you have to have good stability in your shoulder blade muscles and the post because that's where you push from, you have to have a stable base to push from. So I think doing a pulling is very important, just for like the maintenance side of things. And also just being stronger. I mean, shit, you want to have good body lock, dude, you got to have some good, some good squeeze, right? So that's important to I'm trying to think so that's like a pole, or a leg, let me see for a push day. 

 Dr. Jimenez [00:49:49] Yeah, I mean, you're, I usually say the same thing. I usually am like a deadlift girl, like go do deadlifts. And that's just for life. I feel like deadlifts are so important to be able to lift properly and have your low back and core so strong. 

 Eugene [00:50:01] Yeah, deadlifts are great for me. I can't go just my back. My low back is a little temperamental. So sometimes deadlifts feel great. Sometimes they don't. So I do more of an RDL with some dumbbells. Do what works for you, right? Find the if you feel like your backs bothering you, you can't squat, well, maybe do a belt squat or even a leg press if that's something that helps you. I don't think there's anything wrong with doing on a push day. I love a good old bench press. I think benches is a fine movement to use. I'm not trying to bench anybody off me, but having the ability to base and control and have good frames. I think a bench press is very useful. When I lift- With bench press? Yeah, go ahead. 

 Dr. Jimenez [00:50:42] With bend press, I often recommend people do dumbbells because it allows more rotation of the shoulder blades. I see a lot of people come in with injuries. I mean, everybody loves to be on a straight bar, just benching. It's so like sexy, I guess, you know, have big pecs and then they get the pec tears. They get the labrum tears. They get like AC joint stuff going on with their collarbone. And I think the shoulder blade just doesn't, there's no rotation. In the back of the shoulder blades when you're just going straight up and down like this everything's so fixed versus dumbbells I can come out wide and I can go up and press so I often recommend that when people are having shoulder issues 

 Eugene [00:51:19] Dumbbells are great. You know, you're working some different components there You're you have to have a little more stability obviously because you don't have a fixed like a bar That's gives you a little of that stability But I'm doing both like I'm doin a bar But I've also doing some incline type stuff where I'm using some some dumbbells and things like that But having but I go full range of motion. I go nice and slow good controlled eccentric So I'm moving down getting a good little stretch. I'm working full range emotion and don't just bro-lift and. Go real small range and not full range of motion and not control to try to take the momentum out of it and that's a little bit easier on your joints too because you're more time under tension so you're going to have those muscles are going to really get good good fatigue to him with even less reps. 

 Dr. Jimenez [00:52:07] Yeah Cool, so moving on from the cross-training stuff, I wanted to talk a little bit about longevity, age in jujitsu. I think, I'm not sure if you feel the same way, but I always have it in the back of my head that I'm getting older, and it's a little of a fear because I don't want to get older and lose mobility. The science shows that our tissue does change when we age, but what do you think? What do you about aging, jujutsu, and can we do it forever? What can we do to make sure we're healthy? 

 Eugene [00:52:41] I think jiu jitsu has so much variety to it that you can train in some capacity forever. Would your game need to change? You have to go from a very explosive game to a more maybe controlled pressure passing? Sure. Some people are in their 50s and they play rubber garden. They're great because their joints and their bodies accustomed to it. It's just like what you adjust, you have to listen to your body. You have to go based on what feels good. We talked about rotating the tires. You may play a little top game when you feel like you might play a bottom game. You have to find what feels good to your body, but you should be able to move in all the ways like I think you have to kind of give yourself some attention a couple days a week at least on the mobility side of things. So and mobility is not just like having being flexible. It's having control of your range of motion in your full range. It's Having good control. So mobility is very important. So working on that, again, longevity-wise, also this is a very popular, I would say, sports term is load management, and it's just how much stress you put on your body. If you're peaking for a tournament, yeah, you're gonna increase the load, the intensity, but should you train at a high intensity all the time? Absolutely not. I'm not gonna try to one-rep max on a bench press every week. I'm gonna maybe have some ways where I'll work up to it. Or adjust, do different exercises. So I think there's, you know, on the longevity side, you have to listen to your body. I think it's really important. You have to manage the load. You know, if you're not getting enough sleep, work is stressful, maybe you don't train as hard. Give yourself adequate rest, active rest. Don't just lay around and eat like a dummy. You know? Go for walks. Do things that make you feel good. 

 Dr. Jimenez [00:54:38] When they take a rest day, they're like, yeah, I just sat on the couch and ate pizza. Like, that's not a rest thing. 

 Eugene [00:54:44] Like go for a walk, do some things that feel good, get outside. Yeah, I mean, there's so many different elements to like longevity. And I think the big ones are having good strength. So strength training, having, you know, good mobility in your joints. So given some time for that. I think there's benefit to doing like yoga or stretching, I think it's a good recovery thing is, is it something you should be like stretching a ton? It depends if there's an area that that's maybe limited, but Stretching can be helpful for some and not for others people think one of the common Misconceptions of something hurts to stretch it. I'm like, no, that's not it There's so much more could be going on there than a quote-unquote tight muscle So just you have to find works for you. Having a good coach is important, listening to your body is important. Give yourself the things outside of the gym is also really, really important too. So it's not just your time on the mats, you have to change your mindset to thinking of what you do outside of The gym is like part of your training. 

 Dr. Jimenez [00:55:54] Awesome. Well, we're kind of getting close on the hour here. I had a couple of little rapid fire questions that I wanted to ask you. What is one stretch you think everybody should do, but almost nobody does. 

 Eugene [00:56:07] I don't know, that's a good one. 

Dr. Jimenez [00:56:10] I mean I guess just one stretch in general because

Eugene [00:56:13] I like it. So it's like what kind of in a lunge and then you open up. It's called the world's greatest stretch. There's some different ways people do it. But it's a good way to stretch the hip flexor, the kind of that the adductors and adding some rotational components and also like opening up your chest and shoulders. I think it's good, dynamical stretching it good bang for your buck. I mean, I mean people probably do that one. But I don't know, stretching is an interesting one because depends on what you need. 

Dr. Jimenez [00:56:42] Yeah, I agree. I I try to stretch every morning even if it's just three to five minutes and then it's like okay What's tight today? What do I need to kind of work on and I just hold it for 30 seconds minute. Okay What is a position or a submission that you traditionally have loved but maybe had to retire or or slow down on? 

Eugene [00:57:03] Oh i love um so when i train i um i have a pretty good loop choke like i went to a tournament like loop choked everybody so that's a collar grip and so my fingers have you know kind of taken the brunt of it so i will do some loop chokes i know i have it in the bag but i try not to i'll use it sometimes as needed but i don't really try to loop choke as Just to save my fingers 

Dr. Jimenez [00:57:26] You were spamming it. 

Eugene [00:57:27] I'm going to somebody that's really give me a hard time and they're not respecting the cross-collar grip I'll I'll do it just to let them know Back them off a little bit, but I will use it but I try to watch my grips more than any positions I feel pretty comfortable One thing I really like when I had a we talked off the podcast about I had some knee bursitis So I kind of tried to adjust the takedowns that I that I use so I'm not like banging my knee into the ground so definitely still working takedowns, but maybe modifying takedows where my knee doesn't take as much impact. That's probably not really a position but a technique maybe I just try to work on 

Dr. Jimenez [00:58:05] Nice. Well, I know we're doing rapid fire, but talking about the bursitis stuff, I see a lot of athletes in the military too. Anybody that's on their knees a lot, wrestlers with bursitus, can you kind of talk about that a little bit and then we can go over treatments for it. 

Eugene [00:58:20] Yeah, bursitis sucks. So I actually the way it happened for me was I was training with someone and he my training partner kind of like fell back awkwardly and we both landed basically both our body weight like my knee took the impact. So bursa is like a fluid filled sack in the front of your knee and it kind of it can get swollen essentially it's in so you'll feel your knee get kind of hot and swarms feel like there's like a bag of water for me it was like when I was kneeling I felt like it was a bag water. On my knee. So one of the things to do preemptively is obviously limit the activity that's causing the issue. So try to avoid kneeling. So what I tried to do initially, was just to play off my back and do some different positions. And then, you know, elevate, compress, do some compression is kind of helpful. Some people say ice ice is more for pain. But I mean, you can try ice, I don't know, as far as the research goes, if that's really that beneficial. When I went to my ortho he was like you need to ice this thing. I was like cool if you want me to I will But I know compression elevation kind of thing and then Limiting the activity is very important. So but that happens a lot with wrestlers With a lot of grapplers if you're on your knees a lot it can it can cause an issue and then That it's not necessarily limiting in the fact that you can't train Um, but what can happen is you can get it in fact infected. So the the risk really is infection so if you have a Infection your bursa obviously can impact your joints. You know, you don't have an infection being on you know on the mats and stuff It's not a good thing. So the surgeon. But yeah, I think the infection is kind of the main risk there. And the swelling is pretty annoying, I would say, but it does require you to take attention of it because it can get, you know, kind of an annoying, hindering injury. 

Dr. Jimenez [01:00:13] Yeah. And there's different types of bursitis. This is pre-patellar bursitus. So this is like the big, big ball in front of the knee. Cause you can get bursite in the back of the knee. Like there's burses all over your body. But this one, you have one on the elbow too, that sometimes it happens more in older people. I'm not sure why, but you'll see this big ball, like maybe your grandma or something had this huge golf ball on their elbow. Similar there, but we see it in, in grapplers a lot. And there's so many different treatments. I have a story of a wrestler once that I was away competing and she had a pre-potilar bursitis but she would not stop for anything. Like she was just go, go, and she was a phenomenal wrestler, still is. But I get a picture from her mom one night and she's in the bathtub and it had gotten infected and there was just pus draining from her knee, like all in the tub and she just like smiling. Okay. This is in a great situation, you know, you, um, it got infected. It opened on its own because there was so much pressure than nowhere else to go. So she essentially drained it herself. Right. Uh, but I did have to, when I got back that next week, I had to go and, and remove this disgusting bursa that had gotten infected and she got lucky. It burst it on her own, honestly, I think, because if these become infected, you, it gets red and hot. So it's different than just the ball swelling. Red and hot and then it can go into your bloodstream and it can become an infection in your body. So that's the bigger concern for it. But before it becomes infected, there's a lot of different options. Draining it, you can put steroid. We talked about sclerosing agents. There's some research on doxycycline, which is actually an antibiotic, and you can inject some of that in there and it scars down the two tissues. But you don't have to take time off the map. It's not like injection go. You just create the friction, open the space back up. But then sometimes we take them out preemptively. Keeps filling, keeps filling. Let's just go take it out. Right, so prebrotulobrositis is an interesting thing in that it's not super dangerous unless there's an infection. 

Eugene [01:02:16] And I ended up having a drained and then I had drained again because it just swole back up. And I had some cortisone in it. And then I really just took a good amount of time off. I think it was about six weeks. I just wanted to be careful. I didn't wanna have surgery. I didn't wanna have the bursa removed if I could avoid it. So I just kind of, I was telling you, I got the bro lift, just do upper body lifting for about six week. And just took some time off the mats. And when I came back was very gradual, very slow. I use knee pads. I just started looking for different knee pads because I do feel like, now here's the difference and people think they'll think knee pad and they'll they'll thinking their head knee braces. I'm not using a brace for any kind of stability. My knee was not unstable. So when you see certain stuff out there about like, oh, I got this knee brace and it helped my knee feel like stable. That's not, that's not true. That's gonna, there's no research behind it. It's not gonna, it may give you a little compression feel kind of nice, but it's not going to give you kind of adequate. Structural support, but I do feel that if you have some cushioning It can at least help distribute the load a little bit and I have not found a very good knee knee pad I kind of been Looking and i'm in the process of trying to like making maybe a knee pad for for grapplers. That might be a little better Uh than what's out there because i've just tried everything and nothing is really great um, but that that'll be it like just give it some cushion if you If you can and then try to avoid that and get back very gradually to like again, don't just I'm clear to go back I'm just gonna start kneeling again as much as I was very careful with that when I started back to training 

Dr. Jimenez [01:03:56] Yeah, cool. All right. Well just wrapping up here. Where can people find you? 

Eugene [01:04:02] Yeah, so, um, so I have my websites, uh, the jujitsu therapist.com or on social media. Um, so on Instagram, it's the juju therapist and also have a YouTube channel. I do some longer form content on there and, uh you can reach out to me through email or through my website. There's some contact links on there, um and I do some online coaching as well for people that, uh reach out to me and we work together. You know we do mobility work and whatever else they need to get them back on the mat safely and some guidance there. 

Dr. Jimenez [01:04:37] Awesome. Well, thanks so much again for being on on the show and I really appreciate you making the time 

Eugene [01:04:42] Thanks, Meg, I appreciate your time, too.